0:00

Today, I want to talk about the Omicron variant.

So, on Friday, the day after Thanksgiving, I was at a friend’s place having leftovers and I pulled out my phone at the dinner table, which is something you should never do, and Twitter is on fire with news of a new variant.

0:18

First detected and announced that of South Africa called the Omicron variant.

So first I have to learn how to say the word Omicron and then I get completely sucked into the Vortex of Doom, scrolling through my phone for the next half hour.

And what immediately struck me reading all these headlines about a Frank In very, Auntie Polly mutant variant was the gap between data and meaning like within hours of this thing becoming public scientist.

0:45

Could tell you with exquisite detail exactly what the virus looks like exactly how it had evolved or mutated from the OG coronavirus, the original sucker.

So, you’re just reading all this stuff feeling overwhelmed, completely overwhelmed with new information, and I kept scrolling to the part where they said and what Justice I mean, for you for the vaccines for Christmas travel and the answer on every count was we have no idea come back in two weeks, like facts and factoids everywhere.

1:18

Not a drop of meaning.

So in the next few days, I think a lot of people will be in exactly that state, they will be scrolling through their phones, looking at data and not finding meaning.

And so, I think it’s important to be clear about the only 4 questions.

1:35

That matter when it comes to this variant number one, is it more infectious.

Number two, does it cause more severe illness?

Number three, do the vaccines that we have still work against this.

Mutant a number four.

When will we know the answer to questions 1 through 3?

1:53

And since there’s really only one guy I trust more than everybody else to answer those questions.

I called him.

I’m Derrick Thompson.

This is plain English.

2:26

Dr. Peter hotez is the dean of the national school of tropical medicine at Baylor University.

He is the co-director of the Texas Children’s Hospital Center for vaccine development.

He is one of the rare TV figures who appears regularly on CNN and NBC and Fox News, he has been throughout this pandemic.

2:46

One of my top, go to sources for everything about the vaccines, the variance, everything else pandemic related.

So dr.

Hotez, welcome to the podcast.

Thanks so much for having me and good to see you and talk with.

You get to see you too.

3:02

So when I first read the stories about Omicron, scientists were calling it a Frankenstein monster and I’m not asking you to endorse that particular description, but I was Hoping we could start by having you explain what scientists saw with this mutation that caused such alarm.

3:20

Yeah, I certainly wouldn’t call it a Frankenstein monster, but there are some concerning elements to it.

I think one was too steep acceleration in cases that were noted in the to urban areas of South Africa Pretoria and Johannesburg.

There were in the same Province and that caused people to same what’s going on here and with it, you know that the South African Biology Community is very strong in part because it really accelerated during the AIDS era and they have a lot of capacity.

3:51

So molecular biology is really strong in South Africa and they were doing a very good job doing genomic sequencing, and they were sequencing a number of the virus isolates and they saw two concerning Trends one.

Was that the variant in terms of transmissibility had some mutations around What’s called the 681 position.

4:12

Which is known as the fear and cleavage site that we’ve seen with Alpha and Delta are associated with high transmissibility.

And then the second, the one that more people know about is the lots and of mutations in the spike protein, including the receptor binding domain of the spike protein that binds to the Ace 2 receptor.

4:33

So that gave people pause for concern, that was kind of the worst of Both Worlds.

One, you had a, a chant that could be transmissible, like, Alfred l.

Number one, and number two, lots of mutations that potentially could make it partially resistant to the immune responses to vaccines.

4:53

And I think that was the reason why the World Health Organization sounded the alarm and part.

I think because, you know, some of the international bodies have been slow in the past and people we wanted to give a full-on, they want to give a full-on signal that.

5:10

This was a variant of concern.

Learn to synthesize a little bit of what you just said.

The virus hooks into ourselves primarily with this bike protein.

I think of it a little bit like Burrs or a or spores that hook into a sweater.

5:25

They have these little spikes that come out of them and they hook into the cloth of our sweater and that’s how they stick.

And that’s what of how the virus sticks to ourselves and invades our bodies.

And what you’re saying is close enough.

There was enough Coulson.

Okay, close enough for plain English, I guess, and you’re saying that there are mutations.

5:43

In that Spike protein a large and potentially concerning number of mutations.

Why are the number of mutations concerning to scientists the well because in the past, when we’ve seen some key mutations in that part of the spike protein known, as the receptor binding domain, and we’ve seen it at least twice, before we’ve seen it with the beta variant.

6:05

That ironically came out of South Africa.

Last year was also known as the be 1351 or the Lambda variant, that came out of South.

Africa, we’ve seen those, we’ve seen how the antibodies to the vaccines are no longer as effective at neutralizing, the virus and preventing the virus from binding, to The receptors, preventing the Burrs from from binding.

6:28

And now this one is not only has some of the same mutations as beta and Lambda, but has considerably more mutations.

So that the scary situation is whether or not the antibodies to the General vaccines will be able to neutralize the Omicron variant Spike protein changes at all.

6:49

And and I think it will, I think there will be diminished binding.

But if you are my My Hope Is that individuals who’ve got really high levels of virus neutralizing, antibody because they got three doses of the MRNA vaccine or because they’ve been infected and recovered and they got vaccinated.

7:09

I’m hoping that they’ll be enough cross.

S / or what?

I think.

Tony fauci said today spillover of those vaccines to still neutralize the Omicron variant adequately.

And and that will know over the next week or two because our lab is doing those studies, with our vaccine are recombinant, protein vaccine to see if it’ll the antibodies will spill over and neutralize Omicron.

7:33

And I’m certain Pfizer and but Darren and J&J and AstraZeneca were all doing the same experiments, right?

And we’re going to get to the timeline in just a second.

I just want to make Sure that I understand exactly what you’re saying.

So we built these vaccines for the original coronavirus.

7:50

But the coronavirus train that came out of Wuhan or centuries men who hunt, right?

Exactly.

And so, folks that’s been adequate for just about every variant.

It’s crossed neutralized.

The the alpha variant.

The Delta variant.

8:06

The really ones of concern even partial cross.

Neutralized the beta and Lambda, which never really took off, but Has earned, a lot of people because there were a lot of mutations in, in the spike protein.

So the history or precedent would tell us, we should still be okay, but given all the extra mutations that are in Omicron.

8:28

That’s the concern that maybe we’re going to run out of luck this time.

I’m hoping not but it’s it’s, it’s never been more of a possibility.

Yes.

Oh, I have a story in my head and I about these mutations and what they mean, and I want you to tell If that story jives with your understanding of the science, so, the founders of Beyond Tech, which made what we call, the Pfizer vaccine.

8:51

I spoke to them.

And they said the MRNA vaccines sort of holds up like a wanted poster of the virus to the immune system.

They say this is what the bad guy looks like.

And when you confront The Real McCoy, you’ll recognize him stop him.

Before he gets into the town gets into the salon and causes all this Mayhem but the virus is you said produces variance, Alpha Beta gamma, of course.

9:12

Delta and I think of those variants or those mutations as a little bit like the figure in the wanted poster trying on disguises to get inside.

Like I’m anthropomorphizing here.

He’s not trying to on disguise us.

It’s just mutating because of evolution but you know, it’s you know, Alpha puts on the fake nose and Gamma or Delta puts on the fake beard and what worries virologist.

9:33

Is it Omicron has way more mutations on that critical Spike protein than the other variants we’ve seen.

It’s like it’s as if the criminal pictured in The Wanted.

Mr. Went to the costume store and like grabbed every disguised in the center aisle.

And now the scientists are like, we don’t know if he’s got the fake knows.

9:50

He’s got the fake beard.

He’s got the wig on.

We don’t know if the wanted poster at the MRNA, vaccines have shown to our immune system are necessarily going to recognize this mutant the same way.

They have recognized all the previous mutants to what extent, you know, better.

10:08

So I completely put your science.

I’ll run with you or you could say, you know before you know, the The criminal and had a badly fitting, fake mustache, and, and one of those Groucho Marx glasses with the fake nose and mustache.

And now they’ve now they’ve gone and gotten plastic surgery.

So so yeah, I think that that’s, that’s fair enough.

10:28

And whether or not, we’ll still be able to recognize this the Omicron variant.

We’ll know pretty soon, you know, hopefully days a week or a week or so.

The problem is the same.

Neither produces.

10:43

All the pseudo viruses is getting, you know, getting inundated with requests.

So everybody can look at it.

So it’s there’s a capacity problem there too.

Let’s talk about the timeline here.

So it seems to me.

There are three big questions.

One is Omicron more transmissible more contagious than Delta to does it cause more severe illness than Delta and three are the vaccines were taking effective against it.

11:09

When will we know the answer to these questions?

Is it a matter of days?

Or weeks.

Alright.

So the first thing we’re going to need, we’re going to try to find out is is this virus accelerating and other places where it’s popping up.

I mean, we’re hearing a lot of concern expressed and now it’s in several European countries and Australia and Hong Kong and Canada.

11:30

It’s likely in the United States, but is it going to accelerate their?

And that’s, that’s not a guarantee.

So, you know, people are wringing their hands.

The fact that it’s already popped up in so many different places, too.

I say, you know, just about every variant that we’ve ever had has popped up in multiple places at the same time and that’s happened.

11:49

Since the beginning, right when everyone was wringing their hands about the original variant coming out of central China.

We had to put in travel restrictions from China and by that time the virus is already in southern Europe.

And that’s what ignited the terrible epidemic in New York city.

So the fact that it’s in multiple places per se doesn’t really alarm me but in the next week or so, we’ll start to see if things really accelerate with that with this new.

12:12

So that’s the first piece, the second is we’ll get a better sense of severity of illness.

We’re hearing different stories.

Some are saying, it’s only mild illness others.

I tend to doubt that we’ve so far not seen much variation and clinical presentation from variant to varying.

12:30

It’s it’s been there all bad, right?

So, so I doubt we’re going to see much difference there.

Then the third is will get collected information.

About whether it has the capacity to actually out-compete, Delta and that’s the big question.

12:49

Everybody needs to know is because that’s the way this is worked.

We have the original lineage, and with despite all these different variants.

There was one dominant one that took over and that was Alpha that arose out of a nun.

Fax native population UK in 2020 swept across the world and then Delta came along and that was even more transmissible.

13:12

Well, and swept across the world and out competed Alpha.

The question people will want to know is whether Omicron is are competing, Delta.

That’s a pretty high bar because Delta is highly transmissible.

I’d be surprised if it does, but it’s not impossible.

13:29

And then the last thing you want to know is do the virus neutralizing antibodies recognize this new Bandit, right?

This doesn’t have the ability to cross neutralized.

Our spill over to recognize the Omicron variant and that will know over the next week or two.

13:48

So that’s why I, you know, when people ask me about international travel plans, what should we do now?

And this I say look where you know, if you can hold off big decisions for the next couple of weeks, we’ll know a lot more.

And so just to jump in here.

We’re going to know more soon.

14:04

But in the meantime, Christmas is four weeks away.

Hanukkah is literally right now holiday travels already underway.

If people are concerned.

What should they do right now one.

If you’ve only gotten two doses, of the MRNA vaccine is more than six months, get that third immunization, that’ll give you a 30 to 40, fold rise in your virus neutralizing, antibodies.

14:24

Second vaccinate, your kids, if they’re not vaccinated yet, anyone over the age of five and third, if you’ve been infected and recovered, we now have studies coming out of Rockefeller University and Yale, and elsewhere showing that.

If you get vaccinated on top of that, it not only will Of HIV virus, neutralizing antibodies, but it gives you this phenomenon of what’s called epitope broadening to make you more resilient against the variance.

14:50

So, rather than wring, your hands, you know, talk to your loved ones and make certain everybody is taking advantage of this, very impressive luxury that we have here in the United States, which is a widespread availability of vaccines epitope.

Broadening basically, meaning that our immune system recognizes a wide variety of potential covid mutation.

15:10

So it’s go back to the first metaphor.

It’s like the guy in the wanted poster, can’t trick us with fake mustaches anymore because we’re recognizing him in all of his disguises.

I want to summarize for myself.

What I take to be your timeline, because again, timeline is so important.

We’re getting more information about case growth every day, which means we will have a sense of its transmissibility.

15:32

Pretty soon on severe illness.

It might take a little bit longer as we wait to hear about Hospital reports in places like South Africa.

And then on vaccine effectiveness.

This it could take a week or two.

Is that, right?

Well, at least, at least in the test tube, though, the antibody studies against the variance.

15:49

If you have all the reagents, it can move pretty quickly.

I mean, all the companies and we have our antibodies.

It’s a matter of how quickly they get the suit of Iris into their lab and they’ll get some least some early indication within a few days.

And that’s not the same as vaccine Effectiveness studies, but it’ll kind of give you an indication of what this is looking like.

16:10

So we might get some of that.

That vaccine information soon as soon as well.

What scares you more right now?

Is it the potential risk of Omicron or is it the potential for another deadly winter?

16:28

Surge from Delta?

My biggest worry is this next delta waves coming and and we still have too many unvaccinated Americans and and the numbers are horrific since June 1.

We’ve lost 150 thought jejunal and this 150,000 unvaccinated Americans who needlessly through their lives away because they refuse to get vaccinated and, and that was the consequence of this Delta wave over the summer, across the South and Texas and the southern states and to Florida.

17:04

And now it’s going to happen again.

It’s going to happen now, it’s going to start at starting up in the Upper Midwest in Michigan, Wisconsin, Minnesota, some extent New Mexico and this virus Delta is going to pick off all the unvaccinated and now the The, under vaccinated those who are too far out from their second dose and are not getting their third dose.

17:23

They’re also vulnerable and people are infected and recovered, who think they have great immunity.

They don’t they have inconsistent immunity.

So that’s, that’s my that’s overwhelming in my biggest worry.

And, and Omicron.

Yeah, that’s, that’s a concern to we’re, but we’re putting in the infrastructure.

17:41

Not a look at it for right now.

We’re about to get slammed yet again by another big wave.

This winter.

With Delta and so you think that people should get boot anybody who’s available or eligible for the booster shot.

Should get boosted.

Not only, if they are over 65, not only if they’re immunocompromised, you would encourage everybody more than six months away from their last shot, to get the third shot.

18:05

Why is that the case?

And and what’s the the most compelling evidence that you see the boosters really are that valuable?

Well, the compelling evidence is based on studies, about of Israel, showing that there’s a substantial.

Ali, once you get boosted and you not only have a 30 to 40 fold rise in your virus neutralizing antibodies, but you’re 10 times less likely to be hospitalized and to get symptomatic illness and to get infection.

18:31

And I think that’s the piece, that not a lot of people talk about, you know, they’re here, you’re hearing some of my colleagues saying, well, you only vaccinate to protect against hospitalization and and death and I’m saying, no, because you don’t want to get covid.

We now know.

18:47

That a significant percentage of people get long covid, symptoms, lasting 15 months.

And why did I get my third immunization?

I got it.

Well, when I didn’t want to go to the hospital or go to the ICU, but I don’t want to get covid.

I didn’t want to get gray matter brain degeneration and have an MRI.

19:05

That looks like somebody 20 years older than I am and and to have cognitive decline.

And I think that’s the other piece that we’re not talking enough about.

That’s another compelling reason to vaccinate.

Yeah.

So right now the by the administration is currently restricting travel from Southern African countries.

19:28

I wonder what you think about this travel ban strategy, which to be fair is not only the Biden ministration.

There’s a lot of governments in Europe that are doing the same thing.

It seems a little bit strange to me to specifically single out, southern Africa, considering that As you said, I think just maybe 10 minutes ago.

19:50

We know that this virus has likely already spread all over the world to Canada.

It’s almost certainly already here.

If it’s in Canada, it’s almost certainly all over Europe.

What is the deal with this travel ban?

And do you think it’s a smart policy?

20:07

I-i’ve never understood travel bans.

As I said from the beginning, they haven’t worked, you know, when we first implemented travel bans from China and this virus came in from In southern Europe.

Tonight, igniter in New York epidemic.

They have not worked maybe some exceptions or some of the island nations, New Zealand Australia, but overwhelmingly for North America, South America.

20:29

And in Europe, they have not worked and this virus just spreads too quickly and already sneaks into countries very quick because I don’t really understand the logic.

I think part of it may be Optics that you know, the global leaders want to show that.

20:47

Are doing something and that they’re looking out after their populations.

I think ultimately it’s self-defeating because it’s counterproductive.

It makes it harder to work with affected countries and it’s expensive and it’s it drains resources from organizations to implement the travel bans.

21:06

When what we really should be doing is helping the affected countries, where potentially Omicron originated and and help Botswana get Vaccinated Help South Africa, help Mozambique Malawi and namibian and and Tanzania.

21:24

And that’s far, more productive use of our of our energies.

So if travel Bans are bad policy, what is good policy look, like, let’s say you’re Joe Biden or even better, perhaps you have the ear of Joe Biden.

He calls you tonight and says Doctor hotez, what should I do?

21:42

What he tells you?

Here’s what needs to be done.

We, you know, we now know that The alpha Varian a road arose out of an unvaccinated population in the UK in 2020, Delta arose out of an unvaccinated population in India in 2021.

22:00

What did they think was going to happen when you left the entire African continent unvaccinated or 6%?

Vaccinated which basically rounds off 20.

What did you think was going to happen?

So of course, the next big worrisome pandemic threat, varying arose, Out of Africa.

22:16

This was Is both predicted and predictable.

And this is, you know, I overall I think the Bond Administration has done a good job in terms of vaccine policy for the us, but we’re just not seeing that ownership of doing something globally, right?

22:33

I mean, you even heard it today, you know, the president said, well, we’ve sent 275 million doses to 110 countries more than any other country.

I mean, that’s true, but what he didn’t say It was we’ve got a billion people in sub-Saharan Africa.

22:51

We’ve got 600, 700 million people in Latin America.

We have, you know, hundreds of millions of people in the Middle East and the smaller low-income Southeast Asian countries.

We need to vaccinate 3 billion people and not by 2023.

23:06

Now, that means we need nine billion doses.

Where’s the nine billion doses coming from and, and that’s what we need.

And, and the problem is there.

Was never a plan to make nine billion doses of anything.

We certainly can’t do it with mRNA and least at the beginning with any brand new technologies.

23:26

Any engineer would tell you can’t go to 0 to 9 billion.

So by Design we knew we were going to screw over the southern hemisphere.

That was the plan.

That was always the plan.

We were going to leave the Southern Hemisphere unvaccinated and and I said, no, I don’t think we need to do that.

23:43

So that’s why we made our simple, you know.

Protein vaccine, same technology used to make the hepatitis B vaccine that’s been around for 40 years.

That works really.

Well, I think as maybe as good as mRNA vaccines and is made locally in Brazil and India and Indonesia and Bangladesh and and and many other places.

24:07

That’s what we need to do and and nobody nobody would buy into that.

So we’ve been left on our own the whole time.

I’m doing it.

Now, we’ve now Now, technically transferred, the technology to India first.

Hopefully it’ll be releasing for emergency use authorization.

24:22

But had we gotten a fraction of the support that Moderne ghadir or Pfizer.

I think we could have had the world vaccinated by now and even now they’re still no plan to vaccinate the world.

There’s no, there’s no ideas.

Being really put forward of how we’re going to make and deliver nine billion doses now.

24:44

And and then, you know, we heard the president say We need the other countries to step up.

And so, but who’s going to lead?

I mean, we’re not seeing that leadership, right?

I mean, I mean who’s supposed to leave this Putin?

She, I mean, some nameless bureaucrat from the European from the European commission.

25:03

I mean, it now it’s got to be the present United States, and you might say, well that’s not fair to always make America doing us life in the big city.

That’s that’s all it.

That’s always been for the last hundred years that if the US doesn’t lead the Big picture it doesn’t get done and the same as now.

25:21

I want to ask you about vaccine hesitancy.

You and I have talked quite a bit about vaccine hesitancy and vaccine Denial in the United States, but it’s not a purely American phenomenon.

It is a global phenomenon just a week ago.

There was a headline in Bloomberg that South Africa was asking Johnson Johnson finds her to stop, sending vaccines to that country because they couldn’t admit.

25:47

Sure, moored as many doses as they were receiving.

They were hitting the vaccine hesitancy or vaccine denial ceiling after only inoculating about 35% of their adult population.

So, how do we combat?

Not only the vaccine supply problem, which you just mentioned, but also the vaccine demand problem.

26:05

This not just a purely American phenomenon.

It really does appear to be similarly Global.

Yeah.

No, but you know, it’s an american-led initiative.

Unfortunately, the anti-vaccine movement and it’s got Three moving pieces.

And and again, there’s not been the appetite to really take this on.

26:24

So what are the three moving pieces?

Well, right now, in the United States, the number one force, of course, is the aggression coming from the far, right?

Right.

And the statements from members of the US, Congress who’ve declared vaccines as political instruments of control or have said, first.

26:41

We’re going to visit, they’re going to vaccinate you, then they’re going to take away your guns in your Bibles and as ridiculous as that sounds to us.

We’ve got a quarter of the US population, the that believes that.

And so trying to find a way to yank the anti-science out of far-right extremism in the US has and unfortunately it started all in Texas is as I think, been one of the real challenges and so far, nobody’s shown much appetite, take it on, but there are other things we can do the other piece to.

27:08

This is what the center for countering digital hate.

It’s amazing.

We have to have an organization called the center for countering digital hate calls.

The disinformation doesn’t These are a dozen nongovernmental organizations that are responsible for a lot of the content.

And, and that includes, for instance, these fake documentary of the documentary.

27:29

They call it that shows, you know, people of color getting their Pfizer by and Tech vaccine and then it switches over to images of Tuskegee experimentation and makes the statement that the African people are being experimented on and and nobody has an appetite 2D platformer those different Information does and that has to be done.

27:50

And then the third is the Putin government who has had this systematic program of what’s being called weaponized, health communication, which includes discrediting Western vaccines and some, some cases in favor of Sputnik V.

28:06

So that’s caused a lot of problems.

And so the problem is its goes beyond the health sector to know how to dismantle the anti-vaccine Empire.

And I’ve said both, The by the administration and the UN agencies, you know, you can’t leave it to the health sector.

28:21

They don’t know what to do.

But there are people who do the same people who fight Global terrorism or nuclear proliferation or cyber attacks.

We need to bring them in, to create an interagency task force in the US government.

See how we look at that, from State Department, Homeland Security and commerce and justice department because I don’t know how to do it.

28:41

And none of my colleagues in the health sector do either.

And you know, you’ve heard the Surgeon General talked about Facebook and social media.

Your company’s, yeah, they’re disseminating a lot of the stuff but they’re not there.

They didn’t create the content.

So going after the groups that create the content, I think is something that we really need to look at seriously.

29:00

Yeah, but that’s question is about the future of vaccine Innovation.

I know that Moderne right now is working on a multi variant booster.

Beyond Tech is also working on a shot, specifically for Omicron, but is also looking at the possibility of developing, a Shot that could take on all of the variants and we’re going to do is contribute to doing that as well.

29:22

So what is it?

What’s the timeline on that on your progress?

And on the on the progress?

You understand other pharmaceutical companies are having with.

Well, I just sort of, I think to make over moment everything if it’s necessary, and just see if it’s necessary, may not be to make the Omicron equivalent of what we’ve already made.

29:40

I think that’s, that’s not a big going to be a big deal.

I think that’s that’s doable within months to make True Universal, coronavirus vaccine, with a lot of different suggested approaches were taking one to look for some consensus sequence and other approaches.

29:56

I think that’ll that’ll be a bit longer.

I think the other thing to think about moving forward.

So is, you know, trying to build capacity in low and middle income countries to make vaccines.

And again, it should not be on mRNA because there are limits to the technology and to keep and play a variety of Technologies including ones that we use like recombinant protein vaccines.

30:21

I mean, if you remember at the beginning of this pandemic, many of us thought, you know, if you said I couldn’t pick our vaccine is who was going to be the winner.

I would have said the VSP technology that Mark and Company did for the Ebola vaccine.

That was so successful.

And I think even stabilize the African continent that looks really good.

30:41

It was a single dose but a tanked is a for covid-19 if I said, well, what about mRNA or nucleic acid?

Vaccines?

I was in.

Well, those have been around for a couple of decades.

They haven’t really moved anywhere.

The put that I think the lesson learned is for an any new pathogen.

30:59

You don’t know to, you know, so we’re going to have to keep a lot of different Technologies and play.

Great doctor hotels.

Thank you so.

So much for talking us through this confusing moment.

And I will, I will see you in speak to you soon.

Thanks so much.

Appreciate the opportunity.

That’s all we have for today.

31:15

Plain English with Derek Thompson is produced by By Devon manzi, we will be back in your podcast feed on Friday this week.

Talk to you soon.